Psychological disorder or Abnormal behavior
"A psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected." (p.1 par. 1)
"A psychological disorder characterized by marked and persistent fear of an object or situation." (p.1 par. 5)
"A breakdown in cognitive, emotional, or behavioral functioning." (p. 2 par.1)
What are the 3 criteria that define a psychological disorder?
Psychological dysfunction, distress or impairment, atypical response. (p. 2 Fig. 1.1)
Must all three criteria for defining psychological disorder be present in a disorder?
No. They are helpful tools but not necessary requirements for a disorder. (pp. 2-4)
How does the DSM-IV-TR describe behavioral, psychological or biological dysfunction?
"...unexpected in their cultural context and associated with present distress and impairment in functioning, or increased risk of suffering, death, pain, or impairment." (p. 4 par. 1)
What are some professions in the field of Psychopathology?
"...clinical and counseling psychologists, psychiatrists, psychiatric social workers, and psychiatric nurses, as well as marriage and family therapists and mental health counselors." (p. 4 par. 4)
What are mental health professionals who take a scientific approach to their clinical work called?
Scientist-practitioners (p. 4 par. 8)
What is a "presenting problem"?
The reason why a patient came to a hospital or clinic. (p. 5 par. 2)
What is "clinical description"?
"...the unique combination of behaviors, thoughts, and feelings that make up a specific disorder." (p. 5 par. 2)
What is the prevalence of a disorder?
The amount of people in the population as a whole who have the disorder. (p. 5 par. 4)
What is the incidence of a disorder?
The number of new cases that occur in a set period of time. (p. 5 par. 4)
What is the sex ratio?
The "...percentage of males and females who have a disorder and the typical age of onset, which often differs from one disorder to another." (p. 5 par. 4)
What is a chronic course?
The course of a disorder that lasts a long time, sometimes a lifetime. (p. 5 par. 5)
What is an episodic course?
The course of a disorder that is likely to last only a few months, disappear and reappear later. (p. 5 par. 5)
What is a time-limited course?
A disorder that will likely improve without treatment in a relatively short period of time. (p. 5 par. 5)
What is insidious onset?
A disorder that develops gradually over an extended period of time. (p. 5 par. 6)
What are the 3 historical models of human behavior?
Supernatural, Biological and Psychological. (p. 6 par. 9)
Who was the first well known person to postulate the idea that psychological disorder can be treated like any other disease?
Hippocrates (p. 10 par. 3)
Who are the two men most influential in the development of the humoral theory of disorders?
Hippocrates and Galen (p.10 par. 4)
What are the 4 humors that Hippocrates assumed were related to four bodily fluids and whose imbalance could cause psychological disorder?
Blood, black bile, phlegm, and choler or yellow bile. (p. 10 par 4)
A sexually transmitted disease caused by a bacterial microorganism entering the brain, including believing that everyone is plotting against you (delusions of persecution) or that you are God (delusions of grandeur).
What was a great modern development advanced by John P. Grey
Better sanitation, rest, diet , temperature and ventilation in mental hospitals.
What are some new techniques that were developed by the biological tradition?
Insulin shock therapy and electric shock therapy.
What are the basic tenets of moral therapy?
Treating institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction.
Who was influential in removing restraints and chains and implementing positive psychological interventions.
What was an unforeseen consequence of the mental hygiene movement?
A dramatic increase of mental patients because of Dorothy Dix's efforts to make sure all who needed it had access to car including the homeless.
What is one of the most important discoveries in made in the history of psychopathology?
The "discovery" of the unconscious mind.
What is the psychoanalytic model?
Created by Freud it has 3 major facets: 1. The structure of the mind and the distinct functions of personality that sometimes clash with one another. 2. The defense mechanism with which the mind defends itself from these clashes, or conflicts; and 3 the stages of early psychosexual development that provide grist for the mill of our inner conflicts.
The part of our mind that ensures we act realistically. Reality principle. Mediator between id and superego.
Unconscious protective processes that keep primitive emotions associated with conflicts in check so that the ego con continue its coordinating function.
Refusal to acknowledge some aspect of objective reality or subjective experience that is apparent to others.
Transfers a feeling about, or a response to and object that causes discomfort onto another , usually less-threatening object.
Falsely attributes own unacceptable feelings, impulses, or thoughts to another individual or object.
Conceals the true motivations for actions, thoughts, or feelings through elaborate reassuring or self-serving but incorrect explanations.
Substitutes behavior, thoughts or feelings that are the direct opposite of unacceptable ones.
Abnormal behavior develops when the ego is deficient in regulating such functions as delaying and controlling impulses or in marshaling appropriate normal defenses to stronger internal conflicts.
What is object relations?
The study of how children incorporate the images, the memories, and sometimes the values of a person who was important to them and to whom they were emotionally attached.
Who rejected many of the sexual aspect of Freud's theory and introduced the concept of the collective unconscious?
A wisdom accumulated by society and culture that is stored deep in individual memories and passed down from generation to generation.
Who believed that the basic quality of human nature is positive and that there is a strong drive toward self-actualization?
Jung and Alder
What are the 7 tactics that characterized psychodynamic psychotherapy?
1. a focus on affect and the expression of patients' emotions. 2. an exploration of patients' attempts to avoid topics or engage in activities that hinder the progress of therapy 3. the identification of patterns in patients' actions, thoughts, feelings, experiences, and relationships 4. an emphasis on past experiences 5. a focus on patient's interpersonal experiences 6. an emphasis on the therapeutic relationship 7. an exploration of patient's wishes, dreams, or fantasies.
What movement included Maslow (hierarchy of needs) and Rogers (person-centered therapy)?
Humanistic psychology (self-actualization)
Subjects simply report on their inner thoughts and feelings after experiencing certain stimuli.
Individuals are gradually introduced to the object they fear so that the fear can be extinguished.
What 2 developments, important to Psychology, came about in the 1990's?
1 Increasing sophistication of scientific tools and methodology and 2 the realization that no one influence --- biological, behavioral, cognitive, emotional, or social --- ever occurs in isolation.
Who was the most notable early adherent to the idea that psychopathology is multiply determined?
The systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder.
The process of determining whether the particular problem afflicting the individual meets all criteria for a psychological disorder as set forth in the DSM-IV-TR
Application of certain standards to ensure consistency across different measurements.
What are the 5 categories of an individual's behavior covered in a mental status exam?
Appearance and behavior, thought process, mood and affect, Intellectual functioning, and sensorium.
The feeling or state that accompanies what we say at a given point. (example: laughter accompanying a joke.)
If a person is "oriented times three" they are...?
Aware of their surroundings in terms of person, time and place.
What method of assessment is more useful for assessing individuals thoughts, feelings, and behaviors in specific situations or contexts?
What is the focus of observational assessment?
The here and now. The antecedent, behavior and consequences.
What kind of test includes a variety of methods in which ambiguous stimuli, such as pictures of people or things, are presented to people who are asked to describe what they see?
A way of testing to see finding out if someone has a disorder based on test questions that were answered the same by other people with the disorder.
What is the most widely used personality inventory in the United States?
MMPI (Minnesota Multiphasic Personality Inventory
What are positive and negative aspects of the MMPI?
A positive is that there is little room for interpretation. Scoring is objective. A negative is the way in which people may downplay their problems and the time and tedium of taking the test.
What do Neuropsychological tests measure?
Abilities in areas such as receptive and expressive language, attention and concentration, memory, motor skills, perceptual abilities, and learning and abstraction.
A child is given the Bender Visual-Motor Gestalt Test using a series of cards on which are drawn various lines and shapes. The task is for the child to copy what is drawn on the card. The errors on the test are compared to test results of other children of the same age; if the number of errors exceeds a certain amount, then brain dysfunction is suspected. What kind of test is this?
Measurable changes in the nervous system that reflect emotional or psychological events. The measure may be taken either directly from the brain or peripherally from other parts of the body.
Measuring electrical activity in the head related to the firing of a specific group of neurons which reveals brain activity.
Used to determine what is unique about an individual's personality, cultural background, or circumstances. Lets us tailor our treatment to the person.
Classical categorical approach to classification
Assumes that every diagnosis has an underlying pathophysiological cause such as a bacterial infection or a malfunctioning endocrine system.
We note the variety of cognitions, moods and behaviors with which the patient presents and quantify them on a scale.
What is the prototypical approach?
Identifies certain essential characteristics of an entity so that we can classify it. It also allows certain nonessential variations that do not necessarily change the classification.
A negative mood state characterized by bodily symptoms of physical tension and by apprehension about the future is called.
An abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and, possibly dizziness.
What are the 3 types of panic attack?
Situationally bound, unexpected and situationally predisposed.
List at least 7 of the 13 diagnostic criteria for panic attack.
Pounding heart, sweating, trembling, sensations of shortness of breath, feeling of choking, nausea, dizziness, derealization, fear of losing control, fear of dying, numbness, chills or hot flashed.
What is the main difference between anxiety and fear?
Anxiety is more future oriented and fear is an intense present feeling of danger or emergency.
What can parents do for their children to lessen their anxiety later in life?
Provide a secure home base but allow their children to explore their world and develop the necessary skills to cope with unexpected occurrences.
What are the three categories of contribution to anxiety disorders?
Biological, Psychological and Social.
A three part theory of the development of anxiety and related disorders.
Triple vulnerability theory
What are the 3 parts of triple vulnerability theory?
Biological vulnerability, psychological vulnerability and specific psychological vulnerability.
Name a few of the diagnostic criteria for generalized anxiety disorder. (GAD
Excessive anxiety occurring for more days than not for at least 6 months about a number of things, difficulty controlling worry, restlessness, fatigue, difficulty concentrating, Irritability, muscle tension, sleep disturbance, focus of anxiety is not merely a part of another Axis I disorder, causes clinically significant distress or impairment in social, occupational or other important areas of functioning, Disturbance is not directly due to the use of a substance.
How effective are drug vs. psychological treatments for GAD?
In the short term they are about equal but psychological treatment is superior in the long run.
Fear and avoidance of situations in which you would feel unsafe in the event of a panic attack or symptoms.
Avoidance of internal physical sensations that resemble the beginning of a panic attack. (Hot room, argument, exercise...)
A new drug looking promising for treatment of social anxiety disorder or panic disorder.
A child's persistent worry about the safety of the child's parents, loved ones or the child itself.
Separation anxiety disorder
A disorder similar to social phobia experienced by the Japanese in which the individual is anxious of offending people around them with blushing, stuttering, body odor etc.
Name some diagnostic criteria for posttraumatic stress disorder.
Traumatic even that posed a threat to life, injury or physical integrity responded to with intense fear and helplessness, persistent recollection (dreams, intrusive thoughts, distress at exposure to cues that are reminiscent of the trauma), avoidance of stimuli associated with the trauma and numbing of general responsiveness, detachment, reduced interest, restriction of emotional range, sense of foreshortening, persistent symptoms of increased arousal.
A family history of anxiety suggests a what?
A generalized biological vulnerability to anxiety disorders like PTSD.
What is the most widely accepted treatment process for PTSD?
Individuals should face the original trauma, process the intense emotions and develop effective coping procedures in order to overcome the debilitating effects of the disorder.
Intrusive and mostly nonsensical thought, images or urges that the individual tries to resist or eliminate.
How much time do obsessions and compulsions have to take a day?
At least 1 hour and include distress.
What are the 4 types of Symptom subtype in OCD?
Symmetry/exactness, Forbidden thoughts or actions, Cleaning/contamination, Hoarding.
What compulsion is usually associated with needing things to be symmetrical/aligned just so and urges to do things repetitively until they "feel right"?
Putting things in a certain order. Repeating rituals.
What compulsion is usually associated with Fear, urges to harm self or others and fears of offending God?
Checking, avoidance, repeated requests for reassurance.
What compulsion is usually associated with obsessions with germs, fear of germs or contaminants?
Repetitive or excessive washing, using gloves and masks to do daily tasks.
What compulsion is usually associated with a fear or throwing anything away?
Collecting/saving objects with little or no actual or sentimental value such as food wrappings.
What is the key difference between someone who likes to shop and collect and a hoarder?
Hoarders experience strong anxiety and distress about throwing anything away.
OCD individuals equate thoughts with the specific actions or activity represented by the thoughts.
Personality disorders, mental retardation (may include prominent maladaptive personality features and defense mechanisms.)
What are the 4 symptoms the GAF range focuses on?
Depressed Mood, Psychosis, Suicide, Communication.
Designations for various conditions and problems that may be the focus of clinical attention but which in themselves do not constitute a specific mental disorder. within the DSM classification system. DSM lists in "Other Conditions that may be a focus of clinical attention"